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Published in: Current Pulmonology Reports 4/2019

01-12-2019 | Idiopathic Pulmonary Fibrosis | Interstitial Lung Disease (A Hajari Case, Section Editor)

Acute Exacerbation of Idiopathic Pulmonary Fibrosis: Who to Treat, How to Treat

Authors: Tejaswini Kulkarni, Steven R. Duncan

Published in: Current Pulmonology Reports | Issue 4/2019

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Abstract

Purpose of Review

Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are the most frequent cause of death among patients with IPF. Here, we review the revised definition and diagnostic criteria for AE-IPF and discuss management strategies including mechanistically targeted investigational therapies for this complex syndrome.

Recent Findings

Novel therapies targeting various pathways including inflammation, autoimmunity, and coagulation cascade involved in AE-IPF have recently been reported. Although most of these reports are small and uncontrolled, they have provided evidence to design larger randomized, controlled, multicenter studies to improve outcomes among patients with AE-IPF.

Summary

AE-IPF has a dismal prognosis and current treatment consists mainly of supportive care and symptom palliation. There is a lack of consensus on current therapies for AE-IPF, including corticosteroids, but current randomized control studies for newer therapeutic strategies may hold promise.
Literature
4.
go back to reference •• Collard HR, Ryerson CJ, Corte TJ, Jenkins G, Kondoh Y, Lederer DJ, et al. Acute exacerbation of idiopathic pulmonary fibrosis. An International Working Group Report. American journal of respiratory and critical care medicine. 2016;194(3):265–75. https://doi.org/10.1164/rccm.201604-0801CIOfficial guidelines for diagnosis and management of acute exacerbation of idiopathic pulmonary fibrosis. CrossRefPubMed •• Collard HR, Ryerson CJ, Corte TJ, Jenkins G, Kondoh Y, Lederer DJ, et al. Acute exacerbation of idiopathic pulmonary fibrosis. An International Working Group Report. American journal of respiratory and critical care medicine. 2016;194(3):265–75. https://​doi.​org/​10.​1164/​rccm.​201604-0801CIOfficial guidelines for diagnosis and management of acute exacerbation of idiopathic pulmonary fibrosis. CrossRefPubMed
19.
go back to reference Kondoh Y, Taniguchi H, Katsuta T, Kataoka K, Kimura T, Nishiyama O, et al. Risk factors of acute exacerbation of idiopathic pulmonary fibrosis. Sarcoidosis Vasc Diffuse Lung Dis. 2010;27(2):103–10.PubMed Kondoh Y, Taniguchi H, Katsuta T, Kataoka K, Kimura T, Nishiyama O, et al. Risk factors of acute exacerbation of idiopathic pulmonary fibrosis. Sarcoidosis Vasc Diffuse Lung Dis. 2010;27(2):103–10.PubMed
21.
38.
go back to reference Gurwitz JH, Bohn RL, Glynn RJ, Monane M, Mogun H, Avorn J. Glucocorticoids and the risk for initiation of hypoglycemic therapy. Arch Intern Med. 1994;154(1):97–101.CrossRef Gurwitz JH, Bohn RL, Glynn RJ, Monane M, Mogun H, Avorn J. Glucocorticoids and the risk for initiation of hypoglycemic therapy. Arch Intern Med. 1994;154(1):97–101.CrossRef
53.
go back to reference Novelli L, Ruggiero R, De Giacomi F, Biffi A, Faverio P, Bilucaglia L, et al. Corticosteroid and cyclophosphamide in acute exacerbation of idiopathic pulmonary fibrosis: a single center experience and literature review. Sarcoidosis Vasc Diffuse Lung Dis. 2016;33(4):385–91.PubMed Novelli L, Ruggiero R, De Giacomi F, Biffi A, Faverio P, Bilucaglia L, et al. Corticosteroid and cyclophosphamide in acute exacerbation of idiopathic pulmonary fibrosis: a single center experience and literature review. Sarcoidosis Vasc Diffuse Lung Dis. 2016;33(4):385–91.PubMed
57.
69.
Metadata
Title
Acute Exacerbation of Idiopathic Pulmonary Fibrosis: Who to Treat, How to Treat
Authors
Tejaswini Kulkarni
Steven R. Duncan
Publication date
01-12-2019
Publisher
Springer US
Published in
Current Pulmonology Reports / Issue 4/2019
Electronic ISSN: 2199-2428
DOI
https://doi.org/10.1007/s13665-019-00238-7

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